Hepatic metastasectomy for soft-tissue sarcomas: is it justified?
BACKGROUND
Except for patients with gastrointestinal stromal tumors (GIST), systemic chemotherapy in patients with liver metastasis of soft-tissue sarcoma (STS) is not effective. Therefore, all patients with resectable liver metastases underwent surgical therapy. We present our experience with this approach during the last 13 years.


METHODS
All patients (n=45) with liver metastasis of STS undergoing surgical therapy were prospectively analyzed. Clinical and histopathological parameters as well as the postoperative course were recorded. Survival data were analyzed by using the Kaplan-Meier method and the log-rank test.


RESULTS
Twenty-seven of 45 patients with liver metastasis underwent hepatic resection; 59% of these patients had a solitary metastasis, 22% had two metastases, and 18% had three or more metastatic nodules. The surgical perioperative mortality was 7%. The median survival was 44 (range, 1-123) months, and the 5-year survival was 49%. Repeated resection for recurrent tumor was performed in eight patients, which yielded a median survival of 76 months.


CONCLUSIONS
Patients who have hepatic metastases that are functionally and technically resectable should be considered for surgery because this treatment offers the chance for long-term survival (>5 years).
Rehders
A
A
Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsklinikum der Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany. rehders@med.uni-duesseldorf.de
Peiper
M
M
Stoecklein
N H
NH
Alexander
A
A
Boelke
E
E
Knoefel
W T
WT
Rogiers
X
X
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D012086:Reoperation; D012509:Sarcoma / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000473:pathology*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome